Prostate cancer is treated using robotic-assisted laparoscopic radical prostatectomy (RALP). The prevalent treatment has become the standard for localized cancer. This robotic surgery relies on the 45° Trendelenburg position. The patients’ feet are kept higher than the head for surgical access and abdominal visibility. This study explores the position’s effects on patients undergoing RALP.

The pilot study involved 58 patients undergoing RALP at a single center. The control group had 22 patients undergoing robot-assisted partial nephrectomy(RAPN). The demographic data were recorded for all the patients. The study also noted the interoperative parameters like cerebral hemodynamics and oxygenation. The Mini-Mental Status(MMS) exam assessed preoperative and postoperative cerebral function.

The mixed-effects model represented the parametric changes during surgery. Wilcox’s signed-rank test evaluated the MMS result changes. The two groups did not differ in the preoperative assessment of patient characteristics. The typical blood values and vital parameters revealed no differences either. The postoperative MMS exam compared with preoperative values showed no significant difference. The operation and positioning had no adverse effect on cognitive function.

The 45° Trendelenburg position during RALP does not affect postoperative brain function. The cerebral oxygenation does not change even during 5 hour long surgeries. Further studies with large cohorts are necessary to confirm these findings.

Ref: https://bmcurol.biomedcentral.com/articles/10.1186/s12894-020-00774-4